子宫良性转移性平滑肌瘤的临床病理特点  

Clinical and pathological characteristics of benign metastasizing leiomyoma

作　　者：向锦[1] 冯沿芬[1] 张梅芳[1] 梁建中[1] 匡亚玲[1] 吴秋良[1] 

机构地区：[1]华南肿瘤学国家重点实验室,中山大学肿瘤防治中心病理科,广州市510060

出　　处：《实用医学杂志》2010年第2期219-221,共3页The Journal of Practical Medicine

基　　金：广东省卫生厅资助项目(编号:303041146001)

摘　　要：目的:分析子宫良性转移性平滑肌瘤(benign metastasizing leiomyoma,BML)的临床和病理学特点,探讨其病变性质及发病机制。方法:对2例BML进行光镜观察及免疫组化标记,并复习文献。结果:两名育龄期女性患者,均有子宫平滑肌瘤手术史,5～8年后发生肺部多发性结节,其中例2同时伴有腹壁结节及腹腔播撒性结节。术后所有结节病理检验显示为良性平滑肌瘤,且都呈ER和PR阳性,提示其激素依赖性及子宫平滑肌来源。结论:BML是一种罕见却临床经过比较缓和的疾病,多发生在育龄妇女,常有子宫平滑肌瘤切除术病史,几乎都向肺部转移,病理形态学特点及分子生物学研究支持良性平滑肌瘤及子宫平滑肌来源,主要采用手术切除或内分泌治疗,患者常可缓解或治愈,很少再次继发转移或死亡。Objective To analyze the clinical and pathological characteristics of benign metastatic leiomyoma （BML） and elucidate the histopathologic entity and pathologenesis of BML. Methods The clinical, histopathologic and immunohistologic features were analyzed in two cases of benign metastasizing leiomyoma, and the literatures were reviewed. Results Two cases of child-bearing female who were found to have bilateral lung nodules after hysterectomy of her uterus leiomyoma five to eight years ago. Case 2 also had nodules on abdominal wall and widespread nodules in pelvic cavity. Pathologic diagnosis after surgery show that all nodules of two cases were benign leiomyoma with the positive expression of ER and PR suggested their steroid hormone dependent and origination of uteru. Conclusions BML is a rare disease usually occurring in child-bearing females with history of uterus leiomyoma. It always metastated to lung and the histopathologic and molecular biologic characteristics suggested benign smooth muscle tumors and origination of uterus. Surgery excision and endocrine therapy were the major choices, with which patients always released or fully recovered and seldom suffered from secondary metastasis or death.

关 键 词：平滑肌瘤 病理学 临床 肺肿瘤 

分 类 号：R737.33[医药卫生—肿瘤] R735.2[医药卫生—临床医学]